HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.• .Z a Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x-10000ic'
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: .0 7 2 K— qQC if 4 h a'r At 9� IS .c S
Property Tax ID #:y-.r/ / - .SO A - C%0 SS - D 00 ^ 2 _ Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Block No.
p.clYsIA
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
✓lectric _ Plumbing —Sprinklers _ Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
G.r
Cost of Construction: $ a`(Q/i r/ Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name r v
Name:John Law
Address: �� dtlq,oikl"s L` (
Company:Law's Electrical Service Inc.
Address.5158 NW Primm St
City: L s- iTG State: _C f
Zip Code: Sr U / ? Fax:
Phone No. 3 c7 &' I L 2
E-Mail:
City: Pt St Lucie State: F1
Zip Code: 34983 Fax:
Phone No 772 370 4357
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Maiijohniaw5158@aol.com
State or County License EC 13006370 29432
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _, Not Applicable
Name:
Address -
City:
Zip: Phone:
ORMATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: City: State:
Zip: Phone -..-
BONDING COMPANY: _Not
Name:
Address:
City:
Zip: Phone:
._-,. --A nc indimted_
OWNER( CONTRACTOR AFROVIT: Application is nereoy mane co U1JLdM a N= �- -• - - - -
I certify that no work or installation has commenced prior to the issuance of a permit.
St. L de County makes no represer�tation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with and applica le Home Owners Association rules, bylaws or ano covenants that may, restrict or prohibit such
structure. Please consult wiithh your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and st. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non -re dent for
se
WARNING TO OWNER: your failure to Record a Notice of Commencement may result in your paying
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first Inspection. If you intend to obtain_ financing, consult with lender or an attorney before
STATE OF FLORIDA
COUNTY 011
The for Ding rostrum t s acknowledged before me
this day of 20 e�?JN
Name of person making statement
Personally Known FOR Produced Identification
Type of identification
Produced
(Signature of Notary Public- State o
FIACHEL
Commission No. V V =`' T - ('i a t mycommissi
{roml EXPIRES Jai
REVIEWS FRONT ZONING
I COUNTER1 REVIEW 15 REVIEWOR
Rev. 8J2J17
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thksar day of f 20��Y
Name of person making statement
Personally Known r OR Produced Identification
Type of identification
Produced
bf Notary Public- 51
DAVIS _
' �FeF7e RACHEL M
5, 201S (•? `:•( MYCOMMISSION
PLANS I VEGETATION
REVIEW REVIEW